The Importance of End-Systole for Optimal Reconstruction Protocol of Coronary Angiography With 16-Slice Multidetector Computed Tomography

Sanz, Javier; Rius, Teresa; Kuschnir, Paola; Fuster, Valentı́n; Goldberg, Judith D.; Ye, Xiang Y.; Wisdom, Paul; Poon, Michael

doi:10.1097/01.rli.0000153930.34439.e4

Cited by 40 publications

(26 citation statements)

References 38 publications

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“…25 Using a technique termed retrospective image reconstruction, images can be reconstructed at any point in the cardiac cycle. 29,30 Although several types of reconstruction algorithms exist, a proposed optimal reconstruction window for motion-free visualization of the coronary arteries is in mid diastole at 60% to 70% of the R-R interval. 30 Three dimensional volume rendered color images show surface anatomy (figure 1).…”

Section: Image Reconstruction and Interpretationmentioning

confidence: 99%

“…29,30 Although several types of reconstruction algorithms exist, a proposed optimal reconstruction window for motion-free visualization of the coronary arteries is in mid diastole at 60% to 70% of the R-R interval. 30 Three dimensional volume rendered color images show surface anatomy (figure 1). Three dimensional maximum intensity projection and two dimensional multiplanar reformation are used to see inside the heart and visualize the coronary arteries.…”

Section: Image Reconstruction and Interpretationmentioning

confidence: 99%

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Noninvasive Cardiac Imaging with Computed Tomography

Wilson¹,

Gopalakrishnan

Tak³

2007

Clinical Medicine & Research

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Despite major improvements in the treatment of heart disease, it remains a major source of morbidity and mortality on a global scale. Currently, invasive coronary angiography remains the gold standard for identification of obstructive coronary artery disease. However, recent advances in computerized tomographic (CT) techniques of the heart allow for accurate, non-invasive characterization of atherosclerotic coronary disease and other cardiac abnormalities. The calculation of coronary artery calcium scores with electron beam CT has largely been supplanted by high-resolution CT angiography using multi-slice detectors (MSCT) which can provide detailed multidimensional visualization of cardiac structures. Although evaluation of obstructive coronary disease is the primary use of MSCT, its use in identifying congenital defects, planning thoracic procedures and characterizing cardiac function continues to grow. Accordingly, appropriate incorporation of MSCT/CT angiography into clinical practice continues to be defined. Several limitations to MSCT remain which reduce its accuracy, such as in patients with arrhythmia and in patients with either coronary stents or heavily calcified coronaries. Despite its current limitations, MSCT remains a rapidly advancing field and an increasingly valuable tool for the non-invasive evaluation of cardiac pathology.

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Section: Image Reconstruction and Interpretationmentioning

confidence: 99%

Section: Image Reconstruction and Interpretationmentioning

confidence: 99%

Noninvasive Cardiac Imaging with Computed Tomography

Wilson¹,

Gopalakrishnan

Tak³

2007

Clinical Medicine & Research

View full text Add to dashboard Cite

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“…"Motion artifacts" were defined as any blurring of the normally sharply defined vessel contour. 15,18,19 Poor contrast enhancement, motion artifacts, and streak artifacts were considered to be a direct result of our protocol, whereas tiny vessel size, heavy calcification, and pacemaker artifacts were not. Next, we performed a vessel-level analysis in which each coronary artery in each patient was given an overall image-quality grade.…”

Section: Cardiac Cta Evaluationmentioning

confidence: 99%

The Triple Rule-Out for Acute Ischemic Stroke: Imaging the Brain, Carotid Arteries, Aorta, and Heart

Furtado¹,

Adraktas²,

Brasic³

et al. 2010

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Ischemic stroke is commonly embolic, either from carotid atherosclerosis or from cardiac origin. These potential sources of emboli need to be investigated to accurately prescribe secondary stroke prevention. Moreover, the mortality in ischemic stroke patients due to ischemic heart disease is greater than that of age-matched controls, thus making evaluation for coronary artery disease important in this patient population. The purpose of this study was to evaluate the image quality of a comprehensive CTA protocol in patients with acute stroke that expands the standard CTA coverage to include all 4 chambers of the heart and the coronary arteries.

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“…It has been shown that the optimal reconstruction window in which the coronary arteries can be visualized nearly free of motion artifacts starts in mid-diastole (60%-70% of the R-R interval) (27,28). Exceptions are patients with higher or irregular heart rates, in which a reconstruction window positioned in late systole (25%-35% of the R-R interval) often yields the best image quality.…”

Section: Image Reconstructionmentioning

confidence: 99%

Coronary CT Angiography

Hoffmann

Ferencik

Cury

et al. 2007

Journal of Cardiovascular Computed Tomography

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Advances in multidetector CT (MDCT) technology with submillimeter slice collimation and high temporal resolution permit contrast-enhanced imaging of coronary arteries and coronary plaque during a single breath hold. Appropriate patient preparation, detailed technical and technological knowledge with regard to recognition of typical imaging artifacts (such as beam hardening or motion artifacts), and the adequate choice of postprocessing techniques to detect stenosis and plaque are prerequisites to achieving diagnostic image quality. A growing number of studies have suggested that 64-slice coronary CT angiography is highly accurate for the exclusion of significant coronary artery stenosis (.50% luminal narrowing), with negative predictive values of 97%-100%, in comparison with invasive selective coronary angiography. In addition, several studies have indicated that MDCT also can detect calcified and noncalcified coronary atherosclerotic plaques, especially in proximal vessel segments, showing a good correlation with intracoronary ultrasound. Studies on clinical utility, cost, and cost-effectiveness are now warranted to demonstrate whether and how this technique can change and improve the current management of patients with suspected or confirmed coronary artery disease.Key Words: coronary CT angiography; coronary MDCT; coronary artery stenosis; cardiology Nucl Med 2006; 47:797-806 Overt he last five years a dramatic improvement in multidetector CT (MDCT) technology has occurred. The ability to noninvasively image the coronary artery lumen and wall and obtain information on the presence, severity, and characteristics of coronary artery disease (CAD), including the visualization of luminal obstruction and atherosclerotic plaque, constitutes an attractive addition to currently available diagnostic tools, such as nuclear perfusion imaging or invasive selective coronary angiography, for the work-up of patients with known or suspected CAD. JThis review provides detailed information on how to perform state-of-the-art coronary CT angiography (CTA) examinations, including patient preparation, image acquisition, and evaluation techniques. In addition, the potential clinical applications and limitations of the technique are discussed. PATIENT PREPARATIONHigh-quality source images are the most important prerequisite for the diagnostic assessment of coronary CTA. Image quality must be ensured through multiple steps, including patient preparation, the actual coronary CTA scan protocol, and the synchronization of raw image data with electrocardiography (ECG) information, which enables the reconstruction of axial ECG-gated images. Because the injection of iodinated contrast material is necessary to visualize the coronary artery lumen, coronary CTA is absolutely contraindicated in some subjects. Relative contraindications exist with respect to conditions that are known to limit diagnostic image quality. Table 1 summarizes absolute and relative contraindications. PremedicationThe image quality of coronary CTA is substantially im...

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The Importance of End-Systole for Optimal Reconstruction Protocol of Coronary Angiography With 16-Slice Multidetector Computed Tomography

Abstract: Combining ES and MD reconstructions reduces nonevaluable coronary arteries, particularly with higher heart rates. A protocol including 2-3 reconstructions is the most efficient.

Cited by 40 publications

References 38 publications

Noninvasive Cardiac Imaging with Computed Tomography

Noninvasive Cardiac Imaging with Computed Tomography

The Triple Rule-Out for Acute Ischemic Stroke: Imaging the Brain, Carotid Arteries, Aorta, and Heart

Coronary CT Angiography

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